Prolonged unrelieved obstructed labour is the main direct cause of obstetric fistula. The continuous pressure of the baby’s head against the pelvic bone cuts off the blood supply to the tissue of the bladder and sometimes the bowel. As a result the tissue dies and falls out leaving a hole. The woman’s bodily wastes then continuously pass through this hole down the birth passage. The woman is unable to control this. She will remain incontinent for the rest of her life. A lack of access to proper sanitation and health care products mean that she will smell and become an outcast from her community, unless she can receive skilled medical care to repair the hole.